Integrated Care Systems

Howls of protest for death of the NHS 2016 — *Howls of protest for death of the NHS – a campaigner howls and bangs a pan lid*

NHS campaigners came to Downing Street on Friday 23rd December 2016, the day that contracts were signed for 44 areas covering the whole of England to implement the government’s ‘Sustainability and Transformation Plans’ (STP).

Including many health professionals the campaigners saw these plans as the last nail in the coffin of the NHS, effectively handing over the NHS to private companies without any public engagement of consultation, ending a public service whose vision which has long been the envy of the world, signing the NHS over for private profit.

A series of speeches was interrupted every 15 minutes by three long and loud ‘howls of protest‘, timed to coincide with three social media ‘Thunderclaps’ across Facebook, Twitter & Tumblr by several hundreds unable to be there in person.

Among speakers were Paula Peters of DPAC, Ealing Councillor Aysha Raza, trainee nurse Anthony Johnson of the Bursary or Bust campaign, trainee mental health nurse Gina, a patient and campaigner and retired Paediatrician Tony O’Sullivan, Co-chair of Keep Our NHS Public.

*People start a ‘Howl of Protest’ for the NHS*

At the end of the rally, a small group of those present, led by DPAC and a banner listing of few of those who had died because of government cuts marched down Whitehall holding up traffic for a final howl outside Parliament and a speech there by Paula Peters.

*The police got a little aggressive and started pushing the protesters and threatening arrest*

As they came to the end of Parliament Street police came to harass them, threatening them with arrest if they did not get onto the pavement. Like many such police interventions this only prolonged the traffic holdup as the protesters were about to cross the road to the wide pavement outside Parliament but were delayed by police arguing with them.

Sustainability and transformation plans were fortunately short-lived and soon morphed into ‘sustainability and transformation partnerships‘ which by 2018 were becoming known as ‘integrated care systems‘, and then were expected to evolve into ‘accountable care systems‘. It all reflected an increasing half-baked emphasis on managers and management changes which damaged the ability of the NHS to actually treat patients.

Many feel that government policies – under both Tories and Labour – have been designed to wreck the NHS so it can be replaced by an insurance-based system – with great profits for the mainly US-based healthcare companies who make large financial contributions to leading politicians and in which many also have a direct financial interest.

More pictures at Howls of protest for death of the NHS.

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Save Our NHS – The NHS was under attack by the Conservatives before it was established in 1948 and has come under repeated attacks since by governments of both major parties particularly since the 1990s.

Providing universal healthcare costs and the current financial year (2023/24) figure of £160.4 billion is around one seventh of total government spending of around £1,200 billion. So it isn’t surprising that governments should wish to see that the money is being spent wisely. But that isn’t was most changes in government health policy have been about.

Even with that large sum, the UK is still getting healthcare on the cheap. According to Statista the spending per person is less than in the US, Switzerland, Germany, Norway, Netherlands, Austria, Belgium, Australia, France, Sweden, Luxembourg, Canada, Denmark, New Zealand, Ireland and Finland and roughly the same as in Iceland and Japan.

It’s perhaps not surprising given this that we often hear reports which compare the results of NHS care critically with those in other countries. But those reports on the BBC and in the papers seldom if ever mention the poorer funding the NHS receives than many of those with better health outcomes.

The US spend per person is considerably higher than all other countries and roughly two and a quarter times that in the UK. But many of the NHS reforms made this century have been based on making our health system more like the American model, which would be a disaster. But it would mean a great opportunity for private healthcare companies, particularly some of those US companies, to make huge profits at our expense.

A surprising number of our MPs have had some financial interest in healthcare either through shareholdings or by sponsorships. The Daily Mirror in 2014 published a list of 70 MPs with links to private healthcare firms which included almost every leading Tory and some from other parties. As well as then Prime Minister David Cameron, they included Former Health Secretary Andrew Lansley, responsible for the disastrous Health and Social Care Act 2012, Health Secretary Jeremy Hunt, former Health Minister Simon Burns, the Work and Pensions Secretary Iain Duncan-Smith, William Hague, Philip Hammond, Sajid Javid, Oliver Letwin, Chancellor George Osborne, Priti Patel, Jacob Rees-Mogg and many other leading Tories, along with Lib-Dems then in the coalition government Vince Cable, Nick Clegg and Simon Hughes.

It’s these people who have introduced policies which have led to large areas of NHS services being provided by private companies, though still retaining the NHS logo and still providing services free to the public. But generally these are the kind of simple, straightforward services and the more complex areas are still left to the NHS.

There is still huge public support for the NHS, despite its problems some of which have been created possibly deliberately by government reforms to erode that support, though more clearly in a drive to make more of its services available to be taken over by private companies.

On Saturday March 4th 2017, thousands came to Tavistock Square, outside the BMA headquarters to march to Parliament Square in protest against the cuts and privatisation of the NHS which they said was at breaking point.

In particular they were protesting the Sustainability and Transformation Plans for hospital closures and cuts in services which had already caused many premature deaths. Doctors and other healthcare workers clearly saw these as a part of a rapid stealthy privatisation with medical services increasingly being run for private profit rather than public benefit.

In 2017 the STPs mutated into Sustainability and Transformation Partnerships and in 2018 these were told to transform themselves into Integrated Care Systems which have now replaced Clinical Commisioning Groups. These plan, buy, and provide health and care services in there areas and are subject to inspection under 70 performance metrics and can be put into ‘special measures’.

According to the Wikipedia article “A report from the Nuffield Trust in December 2021 found that there was very little evidence that integration policies across the UK – including pooling budgets and creating new integrated boards and committees – had dramatically improved patient experience, quality of services or supported the delivery of more care outside of hospitals.” But clearly they had diverted a considerable amount of expertise, time, energy and money away from the real business of the health service – and funding towards private companies.

Estimates for the number on the march varied even more wildly than usual, but it was clearly a large march. My guess was perhaps 30,000 but it could well have been twice that if not the 250,000 the organisers claimed. All the pictures in this post come from the march and the rally before the start, and I was too tired by the time it reached Westminster to photography the rally in Parliament Square.

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Tag: Integrated Care Systems

Save Our NHS – 4th March 2017